Clinical efficacy of endoscopic plasma resection of juvenile nasopharyngeal angiofibroma
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摘要: 目的 探讨鼻内镜下等离子切除青少年鼻咽纤维血管瘤(juvenile nasopharyngeal angiofibroma，JNA)的临床疗效。方法 回顾性分析2015年1月-2020年1月联勤保障部队第九四〇医院耳鼻咽喉头颈外科收治的12例鼻咽纤维血管瘤患者的临床资料，患者均为青年男性，术前均行影像学检查、数字减影血管造影(DSA)和选择性供血动脉栓塞术，然后在鼻内镜下用等离子切除肿瘤。术后对患者至少进行30个月的随访，行鼻内镜检查观察鼻腔情况，行影像学检查以观察肿瘤复发情况。结果 12例患者术中视野清楚、出血量少、手术时间均在2 h之内，术后恢复时间短。术后随访12例，患者经鼻内镜检查及影像学检查均未见肿瘤复发。结论 术前行选择性颈外动脉栓塞，术中鼻内镜下行等离子切除JNA是安全有效的治疗方法，术中切除干净，能有效提高治愈率，降低复发率，患者生活质量得以提高。Abstract: Objective To investigate the clinical effect of plasma resection of juvenile nasopharyngeal angiofibroma(JNA) under nasal endoscope.Methods The clinical data of 12 cases with JNA treated in the Department of Otorhinolaryngology and head and neck surgery of the 940th Hospital from 2015.01 to 2020.01 were analyzed retrospectively. All of them were young males. Imaging examination, digital subtraction angiography(DSA) and selective blood supply artery embolization were performed before operation, and then plasma was used to remove the tumor under nasal endoscope. The patients were followed up for at least 30 months. During the follow-up, the nasal cavity was observed under nasal endoscope and the tumor recurrence was observed by imaging examination.Results In 12 cases, the vision was clear, the amount of bleeding was less, the operation time was within 2 h, and the postoperative recovery time was short. 12 cases were followed up and no tumor recurrence was found by nasal endoscopy and imaging examination.Conclusion Selective external carotid artery embolization before operation and plasma resection of JNA under nasal endoscope during operation is a safe and effective treatment, which can effectively improve the cure rate and reduce the recurrence rate.
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